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Claims Processing Manager Jobs in Woonsocket, RI

Sweetwater Care

Medicaid Specialist

Boston, MA · On-site

... and manage Medicaid services, ensuring that patients receive the necessary care and support. * Claims Processing and Billing: You will be responsible for processing and billing Medicaid claims ...

AIG

Complex Claims Director, Excess Claims

Boston, MA · Hybrid

$112K - $138K/yr

Advanced experience and capabilities in litigation claims management including ADR and mediation process * Experience attending and controlling cases- pre-suit, litigated and post trial- at ...

MAPFRE

Engineer II/III (Claims)

Webster, MA · On-site

$90K - $150K/yr

In this role, you will develop innovative software applications that streamline claims processing ... managers, and business stakeholders to design, build, test, deploy, and maintain high-quality ...

Hiscox

Portfolio Claims Handler

Boston, MA

... managers, tax preparers, consultants, and other service providers. The assignment includes all aspects of the claims and litigation process and requires coordination with external and internal ...

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Claims Processing Manager information

See Woonsocket, RI salary details

$33.5K

$84.2K

$133.2K

How much do claims processing manager jobs pay per year?

As of Aug 6, 2026, the average yearly pay for claims processing manager in Woonsocket, RI is $84,191.00, according to ZipRecruiter salary data. Most workers in this role earn between $65,200.00 and $100,600.00 per year, depending on experience, location, and employer.

What are the primary challenges faced by a claims processing manager, and how can they be addressed?

Claims Processing Managers often navigate challenges such as ensuring timely and accurate claim adjudication, managing a team with varying workloads, and staying up to date with regulatory changes. Balancing efficiency with compliance requires strong organizational skills and effective communication. Successful managers foster a collaborative environment, implement regular training, and leverage technology to streamline processes, all while maintaining high standards of customer service and data integrity.

What does a claims processing manager do?

A Claims Processing Manager oversees the team responsible for reviewing, evaluating, and processing insurance claims. Their duties include ensuring claims are handled efficiently and accurately, developing procedures to improve workflow, and maintaining compliance with industry regulations. They also resolve complex or escalated claims issues, provide staff training, and report on performance metrics. The role requires strong leadership, analytical skills, and attention to detail to ensure a fair and timely claims process.

What are the key skills and qualifications needed to thrive as a claims processing manager?

To thrive as a Claims Processing Manager, you need expertise in insurance claims procedures, analytical skills, and a solid understanding of regulatory compliance, often supported by a bachelor's degree and relevant industry experience. Familiarity with claims management software, workflow automation tools, and data analysis systems is typically required. Strong leadership, attention to detail, and effective communication are crucial soft skills that set top performers apart in this role. These abilities ensure accurate and efficient claims processing, regulatory adherence, and effective team management, all of which are vital for organizational success.
Claims Processing Manager jobs near you

Medicaid Specialist

Sweetwater Care

Boston, MA • On-site

Full-time

Posted 10 days ago

Job description

Medicaid Specialist

Join the Sweetwater Care Team in Boston, MA!

As a Medicaid Specialist at Sweetwater Care, you will play a vital role in ensuring the seamless delivery of healthcare services to our patients. With a strong focus on patient-centered care, we are seeking a highly skilled and dedicated individual to join our team.

About the Role:

As a Medicaid Specialist, you will be responsible for:

  • Coordination of Medicaid Services: You will work closely with patients, healthcare providers, and insurance companies to coordinate and manage Medicaid services, ensuring that patients receive the necessary care and support.

  • Claims Processing and Billing: You will be responsible for processing and billing Medicaid claims, ensuring accurate and timely submission to minimize delays and denials.

  • Patient Advocacy: You will serve as a patient advocate, addressing concerns and resolving issues related to Medicaid services and billing.

  • Record Keeping and Reporting: You will maintain accurate and detailed records of patient interactions, claims processing, and billing.

Requirements:

  • 2 years of experience in a healthcare setting, preferably in Medicaid coordination or billing

  • High School Diploma or equivalent required; Associates or Bachelor's degree in a related field preferred

  • Strong analytical and problem-solving skills

  • Excellent communication and customer service skills

  • Ability to work in a fast-paced environment and prioritize tasks effectively

  • Familiarity with Medicaid regulations and procedures

If you are a highly motivated and organized individual with a passion for patient-centered care, we encourage you to apply for this exciting opportunity to join our team!

**Apply Today!